Therapist in Kansas City for individuals, couples & families

Sarah Richardson Counseling, LLC
June, 2025

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN ACCESS THIS INFORMATION. 
You may have additional rights under Missouri law. If you have questions about your rights, you are encouraged to seek advice from an attorney licensed in your state.
Under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), you have certain rights regarding the use and disclosure of your Protected Health Information (“PHI”). This Notice explains those rights and my legal duties.
I understand that your health information is personal and confidential. I am committed to protecting your PHI and maintaining its privacy. I create and maintain records of the care and services you receive to provide quality treatment and to comply with legal requirements. This Notice applies to all records of your care created or maintained by this practice. I am required by law to: Maintain the privacy of your PHI, provide you with this notice of my legal duties and privacy practices, abide by the terms of this Notice currently in effect, notify you in the event of a breach of unsecured PHI. I reserve the right to revise this Notice at any time. Any revision will apply to all PHI I maintain. The updated Notice will be available in my office and on my website.
I. How I May Use and Disclose Your PHI
The following categories describe ways I may use and disclose your PHI. Not every example is listed, but all permitted uses fall within these categories:
1. Treatment, Payment, and Health Care Operations: I may use and disclose your PHI without written authorization for: to provide, coordinate, or manage your care. This may include consultation with other healthcare providers, to obtain payment for services provided. This may include billing insurance companies or providing documentation required for reimbursement.To support business operations such as scheduling, quality assessment, supervision, licensing requirements, and administrative functions. Disclosures for treatment are not limited to the minimum necessary standard, as providers may need full access to records to ensure quality care.
2. Legal Proceedings: If you are involved in a lawsuit or legal matter, I may disclose PHI in response to a court order. I may also respond to subpoenas or lawful requests if proper legal procedures are followed.
II. Uses and Disclosures Requiring Your Written Authorization
Certain uses and disclosures require your written authorization.
1. Psychotherapy Notes: I maintain psychotherapy notes as defined by HIPAA (45 CFR §164.501). These notes are kept separately from your clinical record. I will not use or disclose psychotherapy notes without your written authorization except: for my use in providing treatment, for training or supervision, to defend myself in legal proceedings initiated by you, for compliance investigations by the U.S. Department of Health and Human Services, when required by law, to avert a serious threat to health or safety.
2. Marketing: I will not use or disclose your PHI for marketing purposes without your written authorization.
If you provide a testimonial or review and it contains identifiable health information, I will obtain a signed HIPAA authorization before publishing it. You may revoke authorization in writing at any time. Revocation will not affect prior disclosures made in reliance on the authorization.
3. Sale of PHI: I do not sell your PHI.
III. Uses and Disclosures That Do Not Require Authorization
Subject to legal limitations, I may use or disclose your PHI without authorization for: Appointment reminders, information about treatment alternatives or services, when required by federal or Missouri law, public health activities (e.g., reporting abuse or neglect), health oversight activities (audits, licensing), judicial or administrative proceedings, law enforcement purposes, to coroners or medical examiners, to prevent or lessen a serious threat to health or safety, workers’ compensation claims, specialized government functions
IV. Disclosures Requiring Opportunity to Agree or Object
You have the right to decide whether I may share information with family members, friends, or others involved in your care or payment for care. In emergency situations, I may share relevant information if necessary to prevent serious harm.
V. Your Rights Regarding Your PHI
You have the following rights:
1. Right to Request Restrictions: You may request limits on how I use or disclose your PHI. I am not required to agree to all requests. 2. Right to Restrict Disclosure to Health Plans: If you pay for services out-of-pocket in full, you may request that I not disclose related PHI to your health insurer. 3. Right to Confidential Communications: You may request that I contact you in a specific way (e.g., at a certain phone number or address). I will accommodate reasonable requests. 4. Right to Access Your Records: You may request an electronic or paper copy of your records. I will respond within 30 days. A reasonable fee may apply. 5. Right to an Accounting of Disclosures: You may request a list of disclosures made for purposes other than treatment, payment, or operations within the past six years. 6. Right to Request Amendment: If you believe your PHI is incorrect or incomplete, you may request a correction. I may deny the request but will provide a written explanation within 60 days. 7. Right to a Copy of This Notice: You may request a paper or electronic copy of this Notice at any time. 8. Right to Appoint a Personal Representative: If someone has medical power of attorney or is your legal guardian, they may exercise your rights. 9. Right to Revoke Authorization: You may revoke any authorization in writing at any time. 10. Right to File a Complaint: If you believe your privacy rights have been violated, you may file a complaint with: U.S. Department of Health & Human Services, Office for Civil Rights, 200 Independence Avenue, S.W. Washington, D.C. 20201, Phone: (877) 696-6775, Website: www.hhs.gov/ocr/privacy/hipaa/complaints You will not be retaliated against for filing a complaint.
VI. Changes to This Notice
I reserve the right to modify this Notice at any time. Revised notices will apply to all PHI maintained by this practice and will be made available in the office and on the website.

NOTICE OF PRIVACY PRACTICES